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Menstrual disorders

A presentation for Medicos....

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Menstrual disorders

  1. 1. Menstrual Disorders P. Akshay Khumar A Physiological and clinical approach…..
  2. 2. Normal aspects of Menstrual cycle • Cycle length 20-40 days ( Dec. with age advan) • Duration of flow of menses 2-7 days • Avg blood loss 40cc Excess if >80cc • Menses: 50-75% blood • Do not usually clot due to the presence of fibrinolytics
  3. 3. Symptoms….. • Usually unpleasant • Often associated with cramps • Mainly due to hormonal withdrawl
  4. 4. Disorders: Pre-Menstrual syndrome (PMS) Abnormal Menstruation Dysfunctional uterine bleeding (DUB)
  5. 5. Pre-Menstrual syndrome (PMS) • Occurs for 4 to 5 days prior to menstruation • It’s due to water and electrolyte imbalance produced by oestrogen
  6. 6. Abnormal menstruation • Menorrhagia (hypermenorrhea): uterine bleeding excessive in both amount and duration of flow, but occurring at regular intervals. • Metrorrhagia: uterine bleeding occurring at irregular intervals. • Menometrorrhagia: uterine bleeding usually excessive and prolonged occurring at frequent and irregular intervals • Oligomenorrhea: menstrual periods at intervals of more than 35 days. (Decreased frequency) • Polymenorrhea: frequent but regular episodes of uterine bleeding occurring at intervals of 21 days or less.(Increased Frequency) • Hypomenorrhea: uterine bleeding that is regular but decreased in amount. • Intermenstrual bleeding: uterine bleeding, usually not excessive, occurring at any time during the menstrual cycle other than during normal menstruation.
  7. 7. Dysfunctional uterine bleeding (Anovulatory cycle…) • Blood flow is usually excessive in duration, amount and frequency. • More common during the perimenarcheal and perimenopausal years. • Usually episodes are transient and self limiting.
  8. 8. Causes: • Causes for disturbed function can be central, intermediate, end organ, and physiologic. • Central causes: immaturity of the hypothalamic- pituitary axis; traumatic, polycystic ovarian disease. • Psychological factors: anxiety, stress, emotional trauma • Intermediate causes: chronic illness, metabolic or endocrine diseases, nutritional disturbances. • Peripheral causes: functional ovarian cyst, functional tumors, premature ovarian failure • Physiologic: perimenarcheal and perimenopausal
  9. 9. Management: • Control excessive bleeding and recurrence • Iron supplements • Maintain Plasma Volume • Proper nutrition • Symptomatic treatment….
  10. 10. Conclusion • Menstrual disorder is a common complaint. • Specific pathologies are associated with its occurrence in different age groups (pubertal years, reproductive age and perimenopausalperiod). • Requires proper evaluation and specific treatment
  11. 11. Thank You…..